Patient safety for people experiencing advanced dementia in hospital: A video reflexive ethnography. (July 2023)

• Record Type: Journal Article
• Authors: Dadich, Ann; Rodrigues, Jade; De Bellis, Anita; Hosie, Annmarie; Symonds, Tamsin; Prendergast, Justin; Bevan, Alan; Collier, Aileen
• Is Part Of: Dementia. Volume 22:Number 5(2023)
• Page Start: 1057
• Page End: 1076
• Publication Date: 2023-07
• Subjects: Dementia -- patient safety -- hospital -- video-reflexive ethnography -- geriatric evaluation and management unit; Psychiatric social work -- Periodicals; Social work with older people -- Periodicals; Dementia -- Periodicals; 362.19683005
• DOI: 10.1177/14713012231168958
• Languages: English
• ISSNs: 1471-3012

Abstract

Background: Patient safety for people experiencing dementia in acute hospitals is a global priority. Despite national strategies as well as safety and quality guidelines, how safety practices are enacted within the complexities of everyday work are poorly understood and articulated. Methods: Using video reflexive ethnography, this 18-month study was conducted within an inpatient geriatric evaluation and management unit for people experiencing dementia and/or delirium in Australia. Patients, family members, and staff members participated by: allowing researchers to document fieldwork notes and video-record their practices and/or accounts thereof; and/or interpreting video-recordings with researchers to co-analyse and make sense of the data. Results: Safe care for people experiencing advanced dementia involved: negotiating risk via leadership, teamwork, and transparency; practice-based learning through situated adaptation; managing personhood versus protocols by doing the 'right' thing; joyful and meaningful work; as well as incorporating patient and family voices to do safety together. Conclusion: Patient safety for people experiencing dementia requires continuous responsiveness and prioritising in the context of multiple risks by a staff collective with a shared purpose. Ongoing research to better understand how the nuances of patient safety unfold in everyday complex clinical realities in diverse contexts and with key stakeholders is required.